Safety and efficacy of Intraurethral Mitomycin C Hydrogel for prevention of post-traumatic anterior urethral stricture recurrence after internal urethrotomy

Background: evaluation of the safety and efficacy of intraurethral mitomycin c (mmc) hydrogel for prevention of post-traumatic anterior urethral stricture recurrence after internal urethrotomy.methods: a thermoresponsive hydrogel base consisting of 0.8 mg mmc with 1cc water and propylene glycol to pf-127 poloxamer was used in theater. 40 male patients with short,non-obliterated,urethral stricture were randomized into 2 groups: control and mmc. after internal urethrotomy,the mmc group patients received the mmc-hydrogel while the others were just catheterized. both groups had their catheters for at least 1 week. after surgery,they were followed up by means of medical history and physical examination,monitoring voiding patterns and retrograde urethrogram at 1 month,6 months and 1 year after surgery.results: 40 male patients between 14 to 89 years old (mean = 54.15) underwent internal urethrotomy. the average age for the control and mmc group was 54.55±21.25 and 53.75±24.75 respectively. in a comparison of age between the two groups,they were matched (p=0.574). stricture length was 10.7±5.9 and 9.55±4.15 mm for the control and mmc group respectively. there were no statistically meaningful differences between the two groups (p=0.485). fifteen patients had a history of one previous internal urethrotomy which in a comparison between the two groups meant there was no meaningful difference (p=0.327). during postoperative follow up,total urethral stricture recurrence happened in 12 patients: 10 patients (50%) in control group and 2 patients (10%) in mmc group. the difference was statistically significant (p=0.001). there were no significant complications associated with the mmc injection in our patients.conclusions: based on our results,mmc hydrogel may have an anti-fibrotic action preventing post-traumatic anterior urethral stricture recurrence with no side effects on pre-urethral tissue. due to our study limitations,our follow up time and the small number of patients,our results were not conclusive and further studies will be needed with a longer follow up time. © 2016 kums,all rights reserved.